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ERISA, or Employee Retirement Income Security Act, allows you to file a claim for disability benefits with your employer’s insurance.
When filing a claim, be sure to properly review your medical records to correct any errors or omissions. You may assume that your physician agrees that you’re disabled or may assume that an insurance company will agree with your doctor’s conclusions.
These assumptions can cost you a claim, as can failing to submit the proper evidence of your injury or disability.
For a successful claim, you will need to provide evidence of how your medical condition prevents you from performing your job. You need to demonstrate not only that the condition exists but also how, exactly, your condition makes it impossible for you to perform previous job-related duties and requirements.
Apart from having thorough medical records, understanding your employer’s insurance disability policy is very important. Many of my clients aren’t aware of their employer’s policy, have never read it, or have never seen it. Be sure to obtain a copy of this document to review with your attorney.
Doing so will give both of you a better sense of your obligations and will allow your attorney to better represent and assist you.
An analogy I like to use is that you wouldn’t want a foot doctor performing your open-heart surgery. A specialized ERISA claims attorney has a deep familiarity with the rules, regulations, and guidelines of ERISA claims that a general practitioner or even a personal injury lawyer wouldn’t have.
Failing to comply with those regulations during the administrative phase could bar you from having your case heard in court. Hiring an attorney with a keen grasp of ERISA law and policy gives you the greatest chances of success and gives you the representation that you need.
An ERISA lawyer can read your policy, obtain and analyze your medical records, make recommendations based on their review of the document, and ensure that you follow all regulations and guidelines.
Attorney Claudeth Henry is a seasoned and hard-working attorney based in Florida. For over 25 years, she’s helped men and women just like you file and win ERISA claims, even after errors or mistakes in documentation have been made.
Are you worried about your ERISA claim being approved? Have questions about the application process? Reach out to the CJ Henry Law Firm at (352) 577-7746 for a free initial consultation today!
A client of mine had once chosen the wrong date for the beginning of her disability. Because of her medical condition, she had begun working fewer and fewer hours until she could no longer work at all.
She filed a claim for benefits using the date she last worked as her disability onset date, and unbeknownst to her, her employer’s insurance disability policy had a threshold hour to remain covered under the plan. When she fell below the threshold because she was no longer working full-time, she was no longer covered for benefits under the plan. As a result, her claim was denied as there was no coverage in effect on the date of the disability that she chose.
On appeal, we successfully argued that she had been working while she was disabled and was able to establish an earlier onset date for disability than the date that she chose. That was a difficult case, and the odds of winning were slim, but we were very fortunate that her medical records supported our case. Her lack of being able to perform her full duties also helped support that she had been indeed disabled earlier than the date she chose.
This is another reason why it is incredibly important to get a copy of and understand your employer’s insurance disability policy. If you understand that policy, you can avoid the kinds of mistakes that can make a case much harder than it needs to be.
If you begin to notice symptoms, pain, or recurring health issues that could develop into a disability, be sure to get a copy of your employer’s insurance disability policy immediately. But you don’t have to wait until you’re disabled to review and understand the policy.
I strongly recommend that all employees, even healthy ones, have updated and current copies of their employer’s insurance disability policy. Often, this policy is a part of your benefits package; if you’re paying for these benefits, you should know what you’re paying for.
Reviewing the document ahead of time helps you know what is required to prove a disability and obtain those benefits should you experience health problems and disability in the future.
As an attorney, my immediate and pervasive feeling is one of gratitude. I’m grateful that my client chose me to represent them and grateful that the insurance company accepts the arguments that I make on my client’s behalf. I never take that for granted.
For more information on Mistakes To Avoid When Filing An ERISA Claim, an initial consultation is your next best step. Get the information and legal answers you are seeking by calling (352) 577-7746 today.
Attorney Claudeth Henry is a seasoned and hard-working attorney based in Florida. For over 25 years, she’s helped men and women just like you file and win ERISA claims, even after errors or mistakes in documentation have been made.
Are you worried about your ERISA claim being approved? Have questions about the application process? Reach out to the CJ Henry Law Firm at (352) 577-7746 for a free initial consultation today!